Lecture 9.1 - Neurological System Flashcards
After what age is there a steady loss of neurons?
After 65 years
What does the neural atrophy caused by aging do to the rest of the body?
–> Loss of muscle strength and bulk
–> Loss of tone around face/neck/spine
–> Impaired fine motor coordination
–> Decreased reaction time
–> Loss of senses (Touch, pain, taste, and smell)
–> Loss of sense of vibration in ankle, absence of Achilles reflec
Why are older adults predisposed to falls?
Loss of muscle strength and tone, as well is dizziness and loss of balance contributes to more incidence of falling
–> Loss of short term memory also results in forgetfulness about injuries
What might lead to an epilepsy diagnosis?
More than two seizures in 24 hours
What is dysmetria?
Loss of coordination
What is senile tremor?
A slight tremor or shake that is normal in many elderly individuals.
How is Cranial Nerve 1 tested? Is this a part of routine practice?
Check patients sense of smell
–> Check only if you suspect issue
How is cranial nerve II tested?
With the Snellen Chart and a peripheral vision field test.
how is are cranial nerves III, IV, and VI tested?
Test 6 cardinal fields of gaze, check convergence and accommodation.
Inspect pupil size, shape, equality, and light reflex.
Inspect palpebral fissures.
How is cranial nerve V tested for?
Palpate mastication of muscles while clenching teeth
Check sensation on forehead, cheeks, and chin
Corneal test only if you suspect issue.
How should a corneal test be conducted?
With an eyedrop.
–> Used to be checked with a tissue or gauze, but this cause microscopic lesions on the cornea and it cannot be donated.
How is cranial nerve VII tested?
Examine mobility of face while making facial expressions
Check taste only if you suspect issue
How id cranial nerve VIII tested?
Whispered voice test and Romberg test
What is the Whispered Voice Test?
Whispered a sequence of letters/numbers at about arms length from patient.
How are Cranial Nerves XI and X tested?
Examine pharyngeal movement when saying ‘aaaah’
Smoothness of voice when talking
Gag reflex - done only of necessary
Taste - done only if necessary
+ Check ROM and strength of trapezius and sternomastoid
How is cranial nerve XI tested?
Test ROM and strength of trapezius and sternomastoid
How is cranial nerve XII tested?
Examine tongue tone, bulk, and movement
Listen for clarity of speech
What is tandem gait?
Walking heel to toe, as if on a tightrope
What is the one leg hop? When should a shallow knee bend be used instead?
Used to assess balance.
Use shallow knee bend on elderly individuals to prevent falls/injury
What is the Romberg test?
A test used to determine balance.
Ask patient to stand upright with eyes closed for 20 seconds.
Some swaying is normal, but patient should not fall over.
Which coordination tests should be performed on someone during a motor assessment?
- Rapid alternating movements
—> Flip hands quickly on legs - Finger to nose test
–> (eyes closed) - Finger-to-finger
–>E.T - Heel-to-shin
–> Can be done laying or sitting
How can the spinothalamic tract be tested?
–> Pain
–> Temperature (only if necessary)
–> Light touch
How can the posterior column tract be tested?
–> Vibration
–> Position
–> Tactile Discrimination
How can we test for perception of pain?
Sharp or dull test
